Need advice, Mommas!

apark25 · March 2015

Feeling overwhelmed trying to make a decision. My doctor wants to induce me Wednesday. It is my second baby and I will be 40+1. My first baby came 2 weeks early and my water broke on its own at home so this is all uncharted territory.
Doctor is wanting to use Cytotec to jumpstart labor. I am already dilated to a little over a 4 and 60% effaced. Head is engaged and my amniotic sac is "tight and ready to pop".

What would you do? I have had prodromal labor since 34 weeks. I'm exhausted of waiting but also want to do what is best for the baby.

Any advice is welcome.

MrsZ1891 · March 2015

I went through something similar. I'd been having a long drawn out labor and made the choice to be induced via pitocin at 41 weeks 3 days. I was 4cm dilated and 90% effaced. I can't imagine you would need Cytotec.

I labored for 3ish hours before my water started leaking. My midwife broke my waters the rest of the way and I delivered my son about an hour and a half later. I was able to be up and on the birthing ball so that helped with pain and probably the speedy labor. Good luck.

elizalegs · March 2015

Cytotec is a controversial drug which is contraindicated for pregnancy by the manufacturer, the FDA, the WHO ... basically everyone except ACOG recommends against its usage for induction. You can search an earlier thread b/c it came up for another mama recently - to me it is crazy that this still gets recommended because the scientific literature points to a tendency to uterine rupture (admittedly higher for women who have undergone previous C-section).

Some of the comments were like, "Well WE use it in our L&D ward and have no problems..." or moms who had used it and said it worked like a charm... I'm a researcher, so I find this sort of info to be generally unhelpful. One labor and delivery nurse's anecdotes of safety is not enough to convince me in the face of all the stats from published journals. If you start googling you will see some scary stuff, and we definitely get enough of that as preggies, so be warned.

But for you to be as close as you are, Cytotec seems like an absolutely drastic measure, even without the aforementioned risks. I am sure some of the others will disagree with me but for my part it just seems so extreme, especially since you are not that far overdue and there are other, safer, evidence-based interventions that will likely get things going. Hopefully if nothing else this empowers you to have a productive conversation with your care provider.

nicolerae90 · March 2015

I dont think you would need cytotec. Thats more of a dilation drug i thought. A small dosage of pitocin may be all you need. With as far as you are and your water sac is tight, you may not need to even wait for wednesday

growingournest · March 2015

I'm with everyone else- I don't see why you need cytotec. Is there any way your doctor would just break your water and see if that's enough to start labor? You're dilated enough that it might be all you need to get things going.

ngolimento · March 2015

Cytotec is a dilation drug. I had it used on me and my numbers were VERY similar to yours, OP.

My experience was extremely positive with it. It actually amuses me that people cite uterine rupture like it's explicitly the cytotec that raises your risk. Anything that causes contractions has uterine rupture risk. You absolutely cannot be aces about pitocin, then turn around and make another contraction drug sound scarier.

For my experience, Cytotec gently dilated me to 6cm, then my doc started pitocin. Because of it, they did not have to dial my pitocin above an 8 ever (most pitocin inductions go up to 14). It turned a scary induction into a positive experience for me, because my body had time to ramp up, instead of being slammed straight into hard contractions by pit.

elizalegs · March 2015

Peledreamsofrain said:
Cytotec is a dilation drug. I had it used on me and my numbers were VERY similar to yours, OP.

My experience was extremely positive with it. It actually amuses me that people cite uterine rupture like it's explicitly the cytotec that raises your risk. Anything that causes contractions has uterine rupture risk. You absolutely cannot be aces about pitocin, then turn around and make another contraction drug sound scarier.

For my experience, Cytotec gently dilated me to 6cm, then my doc started pitocin. Because of it, they did not have to dial my pitocin above an 8 ever (most pitocin inductions go up to 14). It turned a scary induction into a positive experience for me, because my body had time to ramp up, instead of being slammed straight into hard contractions by pit.

it's great that you had a positive experience - however the OP was asking for truth. one positive experience doesn't negate the fact that many have not been as positively responsive or fortunate in their outcome as you. when a care provider administers it properly under the right circumstances, it can work great. unfortunately it has a history, which some mamas know about and some do not. your single experience does not align itself with the majority of the evidence, however reassuring it may be.

babyh310 · March 2015

I think this largely depends on what kind of labor you want and how miserable you are feeling right now. Inductions can go great, at the same time they tend to run higher risk of needing an epidural due to the pitocin making contractions more intense than natural labor. Epidural can slow things down, often meaning more pitocin or just a longer process. You are also far more restricted in options for delivery positions, more likely to need to deliver on your back, which is the most difficult for you and baby and causes greater risk for tears. However, if you're miserable or they're is a medical necessity for induction, you just have to be flexible and make the best of whatever the day turns out like. The most important thing is you and baby are healthy and safe!

I would encourage you that your body does seem to be progressing on its own... "40 weeks" is an estimate and each mama and baby is different. If you don't want an induction, don't feel you have to have one - you don't! Most practices will let you go to 42 weeks before deeming induction medically necessary. Statistics show better outcomes for birth that happens on its own and with fewer interventions. This is your baby, your body, and your birth. ♡

sugargrenade · March 2015

You're so close to 42 weeks, do you not think you can hold on just a bit longer? the majority of babies will come out on their own by 42 weeks...

(that's just me and i have crunchier opinions on child birth than most of the posters here.)

kelseypie · March 2015

Personally, there's no way I would induce before 42 weeks (no matter the method) unless it was medically necessary. It sounds like your baby is very close to ready.

ngolimento · March 2015

elizalegs said:

Peledreamsofrain said:
Cytotec is a dilation drug. I had it used on me and my numbers were VERY similar to yours, OP.

My experience was extremely positive with it. It actually amuses me that people cite uterine rupture like it's explicitly the cytotec that raises your risk. Anything that causes contractions has uterine rupture risk. You absolutely cannot be aces about pitocin, then turn around and make another contraction drug sound scarier.

For my experience, Cytotec gently dilated me to 6cm, then my doc started pitocin. Because of it, they did not have to dial my pitocin above an 8 ever (most pitocin inductions go up to 14). It turned a scary induction into a positive experience for me, because my body had time to ramp up, instead of being slammed straight into hard contractions by pit.

it's great that you had a positive experience - however the OP was asking for truth. one positive experience doesn't negate the fact that many have not been as positively responsive or fortunate in their outcome as you. when a care provider administers it properly under the right circumstances, it can work great. unfortunately it has a history, which some mamas know about and some do not. your single experience does not align itself with the majority of the evidence, however reassuring it may be.

I would agree with you if my experience was the only one. Many many labors are safely initiated with this drug that the internet likes to post scare statements about, especially people who have never even tried the drug they are setting up as the boogey monster.

If I had listened to all the scare-tactics instead of researching and talking to my doctor, I would have skipped a drug that gave me a birth that I was comfortable and happy with. It took me from a state where I was crying over the loss of my ideal birth to a birth that was amazing and that I have no regrets over.

Again, the statement that it causes abruption is a common tactic people like to use to make this drug sound scary, when the absolute truth is ANY drug that causes contractions carries the exact same risk. Induction comes with this risk, period. But sometimes you have no choice (for me I was past due and my baby was more than 10lbs). I wish more people had posted online about how positive thier induction was without fear of being shot down like this. Maybe then I wouldn't have had a panic attack and been in tears the night before the induction. My experience is valid. Period.

TwinsCitiesMomma · March 2015

I had prodromal labor and had not slept for 30 hours before I came to terms that my plan of having a non-medicated birth was not going to happen. My contractions were strong and about 8 min apart so sleep was impossible. I agreed to an induction at 41w2d when I realized that even if I did fully dilate I would not have the energy to push. If anyone would have asked me if I could wait it out a couple more days, I would have clawed their face off.

We did Pitocin with an epi and I was able to sleep and regain my strength. I don't have experience with cytotec but hopefully OP can ask what her options are, share any concerns, and then make a decision based off of the information presented. In the end, it's all any of us can do.

Good luck OP- keep us updated!

elizalegs · March 2015

Peledreamsofrain said:

elizalegs said:

Peledreamsofrain said:
Cytotec is a dilation drug. I had it used on me and my numbers were VERY similar to yours, OP.

My experience was extremely positive with it. It actually amuses me that people cite uterine rupture like it's explicitly the cytotec that raises your risk. Anything that causes contractions has uterine rupture risk. You absolutely cannot be aces about pitocin, then turn around and make another contraction drug sound scarier.

For my experience, Cytotec gently dilated me to 6cm, then my doc started pitocin. Because of it, they did not have to dial my pitocin above an 8 ever (most pitocin inductions go up to 14). It turned a scary induction into a positive experience for me, because my body had time to ramp up, instead of being slammed straight into hard contractions by pit.

it's great that you had a positive experience - however the OP was asking for truth. one positive experience doesn't negate the fact that many have not been as positively responsive or fortunate in their outcome as you. when a care provider administers it properly under the right circumstances, it can work great. unfortunately it has a history, which some mamas know about and some do not. your single experience does not align itself with the majority of the evidence, however reassuring it may be.
I would agree with you if my experience was the only one. Many many labors are safely initiated with this drug that the internet likes to post scare statements about, especially people who have never even tried the drug they are setting up as the boogey monster.

If I had listened to all the scare-tactics instead of researching and talking to my doctor, I would have skipped a drug that gave me a birth that I was comfortable and happy with. It took me from a state where I was crying over the loss of my ideal birth to a birth that was amazing and that I have no regrets over.

Again, the statement that it causes abruption is a common tactic people like to use to make this drug sound scary, when the absolute truth is ANY drug that causes contractions carries the exact same risk. Induction comes with this risk, period. But sometimes you have no choice (for me I was past due and my baby was more than 10lbs). I wish more people had posted online about how positive thier induction was without fear of being shot down like this. Maybe then I wouldn't have had a panic attack and been in tears the night before the induction. My experience is valid. Period.

Sure. I just want to clarify that I'm not in any way suggesting your birth experience was somehow invalid or that it doesn't matter. However as a researcher who specializes in PGE1/PGE2 mechanisms of action whether as a response to synthetic augmentation of labor or a spontaneous birth with zero interventions, I simply want to share for moms who are seeking to make an informed decision that this is not a risk-free drug. It's not a scare/shame tactic. It's not fear mongering. It's being responsible.

To be given a recommendation by your care provider (who, ostensibly, one has now established a relationship of trust with) and not receive the information that this specific intervention is not recommended by the FDA, by the manufacturer, and by the WHO.... that's not a "tactic" to set up a drug as the "bogey monster". It's sharing info that may not have been made available by the care provider, in a safe forum that doesn't lead to a bunch of terrifying google search results. The OP made statements like, "I feel overwhelmed... what would you do?" I would never presume to tell someone what to do in this situation, others have, and that's their prerogative. My responsibility as someone who does have to read through all of the articles, peer-reviewed and sensationalizing, in my line of work, mandates that I speak up and say, "FYI, it's not without risk". A forum should indeed be a safe place to ask questions, and to give and hear the opinions of all who are participating. I just wanted to clarify that I intended no disrespect to your experience.

To the OP, I commend you for asking questions -- it's your right. May you get exactly the birth you are hoping for!
:-bd

apark25 · March 2015

Thank you all so much for posting! I called and postponed the induction today and will be waiting until he is last a week or more over due. I just feel like I am so very close to him coming on his own that it is not worth the risk of any induction medicine when he is healthy. I will still go in for NST tomorrow to confirm he is okay. Thank you all so much for your advice-- here's to these last few crazy, hormonal, special, days before baby.

Need advice, Mommas!

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